Organization
HILDALE HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EZRA L NIELSEN (OWNER)
(435) 633-6750
Entity
Organization
Contact information
Practice address
20 SOUTH COLVIN STREET, COLORADO CITY, AZ 86021-0459
(435) 633-6750
(435) 201-8680
Mailing address
PO BOX 459, COLORADO CITY, AZ 86021-0459
(435) 633-6750
(435) 201-8680
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
AP4846
AZ
Other
Enumeration date
04/23/2015
Last updated
04/23/2015
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